Headaches and Stress

By mid-afternoon your head feels like a tight band is squeezing it. Or you get headaches most days, and you are taking painkillers more often than you would like. Headaches are very common, especially when life is stressful, and most are not dangerous. But it helps to know what drives them and which ones need urgent attention.

What is happening

The most common type is a tension-type headache: a dull, pressing ache across the forehead or around the head. It is often linked to stress, tight neck and shoulder muscles, poor sleep, skipped meals, not drinking enough water, and long hours looking at screens.

Migraine is different. It is usually a throbbing pain on one side, often with nausea and sensitivity to light and noise, and sometimes flashing lights or zigzags beforehand. Migraines can be triggered by stress, sleep changes, hormones, certain foods or skipped meals.

A common trap is medication-overuse headache. Taking painkillers on many days a month can make headaches more frequent, which leads to more painkillers. Caffeine withdrawal, eye strain from needing glasses, and high blood pressure can also play a part.

Stress and headaches feed each other. Pain makes you tense and worried, and tension makes pain worse. Breaking that loop is where much of the relief lies.

Signs to notice

• Headaches on more days than not
• Pain that builds as the day goes on
• Tight neck, shoulders or jaw
• Needing painkillers several times a week
• Headaches after poor sleep, skipped meals or long screen days

30-second self-check

Answer yes or no for the last month:

• Have you had headaches on eight or more days?
• Do you take painkillers for headaches on more than two days a week?
• Do you often skip meals or drink little water during the day?
• Do you sleep less than six hours on most nights?
• Do you spend long hours on screens without breaks?
• Do headaches stop you from working or looking after your family?
• Has it been more than two years since your eyes were tested?

0-1 yes: Your headaches are probably occasional and manageable. Keep an eye on triggers.
2-3 yes: Your daily habits are likely playing a role. Small changes could reduce headaches.
4 or more yes: Please see a clinic or doctor to check your headaches and your painkiller use.

What you can do next

• Today: Drink a glass of water, eat something, step away from screens, and gently stretch your neck and shoulders. Rest in a quiet, dim room if you can.
• This week: Keep a headache diary: when it started, what you ate, sleep, stress and what you took. Patterns often appear quickly.
• This month: Aim for regular meals, sleep and screen breaks. Get your blood pressure checked at a clinic and your eyes tested by an optometrist.
• Painkillers: Try to use them on no more than two or three days a week, and ask a pharmacist or doctor if you need them more.
• Calm the body: Slow breathing, relaxing your jaw and shoulders, or a short walk can ease tension headaches.

Your tool

Pain Impact Score - a short check of how headaches are affecting your sleep, work, mood and daily life, with next steps and a summary to share with a clinician.

When to get professional help

Call Ambulance 10177 or 112 from a mobile straight away for a sudden, severe headache that feels like the worst ever, reaching full strength within a minute or so. Also call if a headache comes with signs of a stroke: Face drooping, Arm weakness, Speech slurred, Time to call (FAST); or with fever and a stiff neck, confusion, a fit, or after a head injury. See a doctor today for a new headache after age 50, a headache that wakes you and comes with vomiting, or a headache in pregnancy with swelling or blurred vision. See a doctor soon if headaches are becoming more frequent.
Who can help: doctor, nurse, physiotherapist, psychologist, emergency services

Getting help in South Africa

Public clinics can check blood pressure and review your headaches and painkiller use for free, and refer you on. Optometrists offer eye tests, and some medical aids cover them. A physiotherapist can help with neck-related headaches, and a psychologist can teach stress and pain-management skills. If stress is the driver, the Cleared Mind 24-hour Careline on 0800 212 146 can help.